North Region Field Operations Intake Form
Please note: Only current year and previous 2 years data are available in Salesforce.
Nebraska Iowa Area
Rocky Mountain Area
MN Dakota Area
Kansas and Greater Kansas City Area
Your Email Address
Request Date (Today's Date)
Event General Participant
Event Team Captain
If 'Other' Please Explain
What is the request due date?
Event Society Key(s)
What is your goal? What is the business purpose of this request? Be specific and include a call to action.
If this is an event request, please list the full name of the events as they appear in Salesforce. Example: Relay For Life of Gwinnett County CY17, Relay For Life of Gwinnett County CY18, etc. Also provide the State where the event is taking place.
Please submit any documents that you think will be informative or helpful in fulfilling the request. PLEASE DO NOT SUBMIT ANY FILES WITH CUSTOMER DATA.
I am aware of ACS’s minimum necessary standard for data and understand that I am responsible for staying in compliance with the Society’s policies. Such as the ACS Acceptable Use Policy and Information Management Security Policy.
Will you be sharing this information with anyone outside of the American Cancer Society? (i.e. vendors, volunteers)
If so, please identify these individuals by name or role. If you are sharing with vendors, please provide contract number.